Individual
SANTHI P CHENNAREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1240 JESSE JEWELL PKWY SE STE 500, GAINESVILLE, GA 30501-3861
(770) 536-9864
(770) 297-5023
Mailing address
5300 STATE ROAD 64, SUITE 101, GEORGETOWN, IL 60686-0038
(812) 949-5482
(812) 949-5966
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01061425A
IN
207R00000X
Internal Medicine Physician
Primary
82141
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000387032
ANTHEM BCBS
—
05
—
200803790
—
IN
01
—
P00306208
RR MEDICARE
IN
Enumeration date
05/12/2006
Last updated
03/10/2021
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